Sclerotherapy is currently the most frequently used treatment in the field. It is a safe, effective, painless, minimally invasive, affordable method that does not require any convalescence. Sclerotherapy consists of injecting a drug (liquid or foam) directly into the affected vein using a needle. This creates spasm, inflammation and ultimately scarring inside the diseased vein in an attempt to close it permanently. Thus, the blood circulating there will take the path of one of the many other normal veins to go back to the heart.

Initially, a few treatment sessions (on average 3-4), lasting about 20 minutes and spaced out every 4-6 weeks are generally necessary in order to optimize the results. The approximate treatment plan will be offered to you by the doctor during the evaluation. It is important to know that symptoms can be quickly relieved after a sclerotherapy session, while visual improvement will occur more gradually. Since varicose disease is chronic, it is normal for other varicose veins or spider veins to form over time. An annual check-up appointment could be suggested to you so that you do not have to resume the entire treatment after a few years.

Other types of treatment are sometimes indicated depending on the severity of venous insufficiency and a person’s medical condition. These are endovascular techniques (laser or radiofrequency) and surgery. During the evaluation, the doctor will discuss the options that apply to you and refer you if necessary.

The most common side effects of sclerotherapy are bruising and tenderness/induration of the treated vein due to the inflammation created there. When present, these disappear in less than 10 days. Other mild reactions may occur either:

• Cutaneous hyperpigmentation (10-30%) – 99% of which will have disappeared spontaneously after 6-12 months.
• The “matting” or appearance of new telangiectasias (10-15%) – will disappear in 3-6 months, otherwise can be treated at the next appointment
• Transient neurological symptoms such as headache or blurred vision (1-2%)
• Thrombophlebitis (< 1:1000)
• More serious reactions such as a pulmonary embolism or an allergic reaction are extremely rare.

For the 2 weeks post-treatment, a few simple instructions should be followed in order to limit the occurrence of adverse effects:

• Wearing 20-30mmHg compression stockings on the knees (minimum 2 weeks, ideally every day)
• Taking acetaminophen as needed/li>
• Walk at least 30 minutes a day
• Avoid heavy lifting and impact activities
• Avoid hot baths and direct exposure to sunlight
• Avoid long periods of downtime, especially air travel